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                <div class="f-title">当前位置：<span class="js_index">首页</span> > <span>家庭医生服务</span> > <span>家医签约服务</span></div>
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                        <p class="bg js_my_doctor"><span class="pic icon1201"></span><span class="word">我的家医</span></p>
<p class="js_change_an hide bg"><span class="pic icon1202"></span><span class="word ">建党档案</span></p>
                        <p class="js_change_jy bg"><span class="pic icon1202"></span><span class="word">更换家医</span></p>
                        <p class="js_jy_package bg"><span class="pic icon1203"></span><span class="word">家医服务包</span></p>
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                            <p class="base df"><span>基本服务包</span><span>></span></p>
                            <p class="base df hui"><span>基本服务包</span><span>></span></p>
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                        <p class="js_suggestion bg"><span class="pic icon1204"></span><span class="word">意见和建议</span></p>
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                        <p class="tab  bb df" ><span class="color" >基本医疗服务</span><span>公共卫生服务</span><span>健康管理服务</span></p>
                        <ul  class="bb">
                            <li>
                                <p class="df first"><span class="circle" ></span><span class="tit">1、预约就诊：</span></p>
                                <p class="second bb" >为签约居民提供专人管理、专人诊疗预约时间随到随诊，避免等候</p>
                            </li>
                            <li>
                                <p class="df first"><span class="circle" ></span><span class="tit">2、预约转诊：</span></p>
                                <p class="second bb" >全科医生解决不了的疑难问题，直接转诊至大医院相关专家大医院开辟社区转诊专用窗口</p>
                            </li>
                            <li>
                                <p class="df first"><span class="circle" ></span><span class="tit">1、预约就诊：</span></p>
                                <p class="second bb" >为签约居民提供专人管理、专人诊疗预约时间随到随诊，避免等候</p>
                            </li>
                            <li>
                                <p class="df first"><span class="circle" ></span><span class="tit">1、预约就诊：</span></p>
                                <p class="second bb" >为签约居民提供专人管理、专人诊疗预约时间随到随诊，避免等候</p>
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                        <p class="title">意见和建议</p>
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                        <div class="tit bb">您还未在广内社区卫生服务中心建档，请如实填写以下信息建档信息</div>
                        <!-- 基本情况 -->
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              <p class="tits df"><span class="icon"></span><span>基本情况</span></p>
              <div class="w-con df bb">
                <div class="w-left bb w">
                  <p class="row bb df"><span class="t">姓名:</span><input type="text" class="bb" placeholder="请输入您的真实姓名"></p>
                  <p class="row bb df"><span class="t">出生日期:</span><input type="text" class="bb" placeholder="2018-01-31"></p>
                  <p class="row bb df"><span class="t">籍贯:</span><input type="text" class="bb" placeholder="请输入您的籍贯"></p>
                  <p class="row bb df"><span class="t">婚姻状况:</span><span class="circle bb yi"><i></i></span><span class="word">未婚</span>
                    <span class="circle bb er cb"><i class="cg"></i></span><span class="word">已婚</span></p>
                  <p class="row bb df"><span class="t">工作单位：</span><input type="text" class="bb" placeholder="请输入您的工作单位"></p>
                  <p class="row bb df"><span class="t">职业：</span><input type="text" class="bb" placeholder="请输入您所从事的职业"></p>
                  <p class="row bb df"><span class="t">单位电话：</span><input type="text" class="bb" placeholder="请输入您单位电话"></p>
                  <div class="block bb">
                    <p class="row bb df rows"><span class="t">现住址：</span><input type="text" class="bb" placeholder="请输入现在居住的详细地址"></p>
                    <p class="row bb df rows"><span class="t">邮政编码：</span><input type="text" class="bb" placeholder="请输入邮政编码"></p>
                    <p class="row bb df rows"><span class="t">所属派出所：</span><input type="text" class="bb" placeholder="请输入派出所名称"></p>
                    <p class="row bb df rows"><span class="t">所属居委会：</span><input type="text" class="bb" placeholder="请输入所属居委会"></p>
                    <p class="row bb df rows"><span class="t">住宅电话：</span><input type="text" class="bb" placeholder="请输入住宅电话"></p>
                    <p class="row bb df rows"><span class="t">本人手机：</span><input type="text" class="bb" placeholder="请输入自己手机号"></p>
                    <p class="row bb df rows"><span class="t">联系人姓名：</span><input type="text" class="bb" placeholder="请输入紧急联系人姓名"></p>
                    <p class="row bb df rows"><span class="t">联系人电话：</span><input type="text" class="bb" placeholder="请输入紧急联系人电话"></p>
                  </div>
                  <div class="block bb">
                    <p class="row bb df rows"><span class="t">定点医疗单位</span></p>
                    <p class="row bb df rows"><input type="text" class="bb" placeholder="请输入您的医疗单位"><span class="add t">+</span></p>
                  </div>
                </div>
                <div class="w-right bb w">
                  <p class="row bb df"><span class="t">性别:</span><span class="circle bb yi"><i></i></span><span class="word">男</span>
                    <span class="circle bb er cb"><i class="cg"></i></span><span class="word">女</span></p>
                  <p class="row bb df"><span class="t">身份证号:</span><input type="text" class="bb" placeholder="请输入您的身份证号"></p>
                  <p class="row bb df"><span class="t">民族:</span><input type="text" class="bb" placeholder="请输入您的民族"></p>
                  <p class="row bb df"><span class="t">文化程度：</span><input type="text" class="bb" placeholder="请输入您的学历"></p>
                  <p class="row bb df"><span class="t">常住类型：</span><span class="circle bb yi"><i></i></span><span class="word">户籍</span>
                    <span class="circle bb er cb"><i class="cg"></i></span><span class="word">非户籍</span></p>
                  <div class="row bb df">
                    <p class="l t">血型：</p>
                    <div class="s">
                      <p class="bb df borderb">
                        <span class="circle bb "><i></i></span><span class="word">A型</span>
                        <span class="circle bb san cb"><i class="cg"></i></span><span class="word">B型</span>
                        <span class="circle bb san cb"><i class="cg"></i></span><span class="word">O型</span>
                        <span class="circle bb san cb"><i class="cg"></i></span><span class="word">AB型</span>
                        <span class="circle bb san cb"><i class="cg"></i></span><span class="word">不详</span>
                      </p>
                      <p class="bb df">
                        <span class="circle bb  cb"><i class="cg"></i></span><span class="word">RH：阴性</span>
                        <span class="circle bb si cb"><i class="cg"></i></span><span class="word">RH：阳性</span>
                        <span class="circle bb wu cb"><i class="cg"></i></span><span class="word">不详</span>
                      </p>
                    </div>
                  </div>
                  <div class="block bb">
                    <p class="row bb df rows radius"><span class="t">医疗费用支付方式</span></p>
                    <div class="checks bb">
                      <p class="row bb df rows c"><input type="checkbox" class="bb check"><span class="t">城镇职工基本医疗保险</span>
                      </p>
                      <p class="row bb df rows c"><input type="checkbox" class="bb check"><span class="t">城镇居民基本医疗保险</span>
                      </p>
                      <p class="row bb df rows c"><input type="checkbox" class="bb check"><span class="t">新型农村合作医疗</span>
                      </p>
                      <p class="row bb df rows c"><input type="checkbox" class="bb check"><span class="t">贫困救助商业医疗保险</span>
                      </p>
                      <p class="row bb df rows c"><input type="checkbox" class="bb check"><span class="t">全公费</span>
                      </p>
                      <p class="row bb df rows c"><input type="checkbox" class="bb check"><span class="t">全自费</span>
                      </p>
                      <p class="row bb df rows c"><input type="checkbox" class="bb check"><span class="t">其他</span> </p>
                    </div>
                  </div>
                  <div class="block bb">
                    <p class="row bb df rows"><span class="t">医保号：</span><input type="text" class="bb" placeholder="请输入您的医保账号"></p>

                  </div>

                </div>
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              <div class="mbtn"><span class="btn">下一页</span></div>
            </div> -->
                        <!-- 健康情况 -->
                        <!-- <div class="health bb cs" >
                            <p class="tits df" ><span class="icon" ></span><span>健康情况</span></p>
                            <div class="heal bb df" >
                                <div class="heal-left heal-com" >
                                    <div class="block bb" >
                                        <p class="h-first bb border-b" >体检</p>
                                        <p class="h-second bb border-b df" ><span class="h-w h-w1" >身高：</span><input type="text" placeholder="请输入您的身高"  class="h-w h-w3 bb"><span class="h-w h-w2">cm</span></p>
                                        <p class="h-second bb border-b df" ><span class="h-w h-w1" >体重：</span><input type="text" placeholder="请输入您的体重"  class="h-w h-w3 bb"><span class="h-w h-w2">kg</span></p>
                                        <p class="h-second bb border-b df" ><span class="h-w h-w1" >腰围：</span><input type="text" placeholder="请输入您的腰围："  class="h-w h-w3"><span class="h-w h-w2">cm</span></p>
                                        <p class="h-second bb border-b df" ><span class="h-w h-w1" >臀围：</span><input type="text" placeholder="请输入您的臀围："  class="h-w h-w3"><span class="h-w h-w2">cm</span></p>
                                        <p class="h-second bb border-b df" ><span class="h-w h-w1" >收缩压：</span><input type="text" placeholder="请输入您的收缩压（高压）"  class="h-w h-w3"><span class="h-w h-w2">mmHg</span></p>
                                        <p class="h-second bb border-b nob df" ><span class="h-w h-w1" >舒张压：</span><input type="text" placeholder="请输入您的舒张压（低压）"  class="h-w h-w3"><span class="h-w h-w2">mmHg</span></p> 
                                    </div>
                                    <div class="block bb" >
                                        <p class="h-first  bb border-b" >既往史</p>
                                        <div class="sblock bb" >
                                            <div class="bb border-b df s-p" ><p class="s-word  df s-word1" >疾病史</p><p class="df s-word2"><span class="circle bcircle bb" ><i></i></span><span class="s-word">无</span></p><p class="df s-word2"><span class="circle bb" ><i ></i></span><span class="s-word">有</span></p></div>
                                            <div class="bb border-b df s-p" ><p class="s-word  df s-word1" >手术</p><p class="df s-word2"><span class="circle bcircle bb" ><i></i></span><span class="s-word">无</span></p><p class="df s-word2"><span class="circle bb" ><i ></i></span><span class="s-word">有</span></p></div>
                                            <div class="bb border-b df s-p" ><p class="s-word  df s-word1" >外伤</p><p class="df s-word2"><span class="circle bcircle bb" ><i></i></span><span class="s-word">无</span></p><p class="df s-word2"><span class="circle bb" ><i ></i></span><span class="s-word">有</span></p></div>
                                            <div class="bb border-b df nob s-p" ><p class="s-word  df s-word1" >输血</p><p class="df s-word2"><span class="circle bcircle bb" ><i></i></span><span class="s-word">无</span></p><p class="df s-word2"><span class="circle bb" ><i ></i></span><span class="s-word">有</span></p></div>                                       
                                        </div>                                                         
                                    </div>
                                    <div class="block bb" >
                                        <p class="h-first bb border-b" >饮食习惯</p>
                                        <div class="sblock bb" >
                                            <p class="bb border-b df eat" ><input  type="checkbox" class="box" ><span class="s-word">荤素均匀</span></p>
                                            <p class="bb border-b df eat" ><input type="checkbox" class="box"><span class="s-word">荤食为主</span></p>
                                            <p class="bb border-b df eat" ><input type="checkbox" class="box" ><span class="s-word">素食为主</span></p>
                                            <p class="bb border-b df eat" ><input type="checkbox" class="box" ><span class="s-word">嗜盐</span></p>
                                            <p class="bb border-b df eat" ><input type="checkbox" class="box" ><span class="s-word">嗜酒</span></p>
                                            <p class="bb border-b df eat" ><input type="checkbox" class="box" ><span class="s-word">嗜糖</span></p>
                                            <p class="bb h-second border-b df eat" ><span class="h-w" >饮食量:</span><input type="text" placeholder="请输入您的饮食克数"  class="h-w h-w3"><span class="h-w h-w2">克/次</span></p>
                                            <div class="bb border-b df nob s-p" ><p class="s-word  df s-word1" >摄盐情况</p><p class="df s-word2"><span class="circle bcircle bb" ><i></i></span><span class="s-word">适中</span></p><p class="df s-word2"><span class="circle bb" ><i ></i></span><span class="s-word">偏咸</span></p><p class="df s-word2"><span class="circle bb" ><i ></i></span><span class="s-word">偏咸</span></p></div>                                                                   
                                        </div>
                                    </div>
                                </div>
                                <div class="heal-right heal-com" >
                                    <div class="block bb" >
                                        <p class="h-first bb border-b" >暴露史</p>
                                        <div class="h-second eat  abox df bb" ><p class="bao df" ><input class="box" type="checkbox"><span class="s-word">无</span></p><p class="bao df" ><input class="box" type="checkbox"><span class="s-word">化学品</span></p><p class="bao df" ><input class="box" type="checkbox"><span class="s-word">毒物</span></p><p class="bao df" ><input class="box" type="checkbox"><span class="s-word">射线</span></p></div>
                                    </div>
                                    <div class="block bb" >
                                        <div class="bb df s-p" ><p class="s-word  df s-word1 bing" >残疾情况</p><p class="df s-word2"><span class="circle bcircle bb" ><i></i></span><span class="s-word">无</span></p><p class="df s-word2"><span class="circle bb" ><i ></i></span><span class="s-word">有</span></p></div>
                                    </div>
                                    <div class="block bb" >
                                        <div class="bb df s-p" ><p class="s-word  df s-word1 bing" >饮酒史</p><p class="df s-word2"><span class="circle bcircle bb" ><i></i></span><span class="s-word">无</span></p><p class="df s-word2"><span class="circle bb" ><i ></i></span><span class="s-word">有</span></p></div>
                                    </div>
                                    <div class="block bb" >
                                        <div class="bb df s-p" ><p class="s-word  df s-word1 bing" >吸烟史</p><p class="df s-word2"><span class="circle bcircle bb" ><i></i></span><span class="s-word">无</span></p><p class="df s-word2"><span class="circle bb" ><i ></i></span><span class="s-word">有</span></p></div>
                                    </div>
                                    <div class="block bb block1" >
                                        <div class="bb df s-p" ><p class="s-word  df s-word1 bing" >体育锻炼情况</p><p class="df s-word2"><span class="circle bcircle bb" ><i></i></span><span class="s-word">无</span></p><p class="df s-word2"><span class="circle bb" ><i ></i></span><span class="s-word">有</span></p></div>
                                    </div>
                                    <div class="block bb" >
                                        <p class="h-first bb border-b" >遗传病史</p>
                                        <div class="sblock bb" >
                                            <div class="bb border-b df s-p" ><p class="s-word  df s-word1" >父亲</p><p class="df s-word2"><span class="circle bcircle bb" ><i></i></span><span class="s-word">无</span></p><p class="df s-word2"><span class="circle bb" ><i ></i></span><span class="s-word">有</span></p></div>
                                            <div class="bb border-b df s-p" ><p class="s-word  df s-word1" >母亲</p><p class="df s-word2"><span class="circle bcircle bb" ><i></i></span><span class="s-word">无</span></p><p class="df s-word2"><span class="circle bb" ><i ></i></span><span class="s-word">有</span></p></div>
                                            <div class="bb border-b df s-p" ><p class="s-word  df s-word1" >兄弟姐妹</p><p class="df s-word2"><span class="circle bcircle bb" ><i></i></span><span class="s-word">无</span></p><p class="df s-word2"><span class="circle bb" ><i ></i></span><span class="s-word">有</span></p></div>
                                            <div class="bb border-b df nob s-p" ><p class="s-word  df s-word1" >子女</p><p class="df s-word2"><span class="circle bcircle bb" ><i></i></span><span class="s-word">无</span></p><p class="df s-word2"><span class="circle bb" ><i ></i></span><span class="s-word">有</span></p></div>                                       
                                        </div>                                                         
                                    </div>
                                    <div class="block bb" >
                                        <p class="h-first bb border-b" >药物过敏史</p>
                                        <div class="sblock bb" >
                                            <p class="bb border-b df eat" ><input  type="checkbox" class="box" ><span class="s-word">无</span></p>
                                            <p class="bb border-b df eat" ><input type="checkbox" class="box"><span class="s-word">青霉素</span></p>
                                            <p class="bb border-b df eat" ><input type="checkbox" class="box" ><span class="s-word">磺胺</span></p>
                                            <p class="bb border-b df eat" ><input type="checkbox" class="box" ><span class="s-word">链霉素</span></p>
                                            <p class="bb border-b df nob h-second eat" ><input type="checkbox" class="box" ><span class="s-word">其他：</span><input type="text" placeholder="请输入您过敏药物的名称" class="h-w h-w3"></p>
                                        </div>
                                    </div>
                                    <div class="block bb">
                                        <p class="h-first bb border-b" >睡眠情况</p>
                                        <div class="sblock">
                                            <p class="bb h-second   border-b df eat" ><span class="h-w" >饮食量:</span><input type="text" placeholder="请输入您的饮食克数"  class="h-w h-w3"><span class="h-w h-w2">克/次</span></p>
                                            <div class="bb border-b  df nob s-p" ><p class="s-word  df s-word1" >睡眠障碍：</p><p class="df s-word2"><span class="circle bcircle bb" ><i></i></span><span class="s-word">无</span></p><p class="df s-word2"><span class="circle bb" ><i ></i></span><span class="s-word">有</span></p></div>                                                                   
        
                                            
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                                <p class="fir" ><span>王医生</span><span class="comword">主治医生</span></p>
                                <p class="comword pp">广内社区卫生服务中心</p>
                                <p class="comword pp">联系电话：010-55456756</p>
                                <p class="comword pp">手机：010-55456756</p>
                                <p class="comword pp">地址：西城区校场五条49号</p>
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